Doctors are not issued with guidelines on how to apply “Catholic moral teaching” when a pregnant woman is in need of lifesaving treatment that could harm her unborn baby, Times of Malta is informed.
National health ethics committee chairman Pierre Mallia recently told this newspaper: “Maltese law usually respects Catholic moral teaching as the normative value. This allows for harm to be caused, including death (to the unborn child) when it is foreseen, indirect and unintended.”
He explained that medics would strictly follow the ethical principle of double effect (see below) when faced with a pregnant woman in need of treatment that could harm her unborn child.
Asked to clarify whether medical personnel were issued with guidelines on how to apply this principle in such situations, Prof. Mallia replied: “Not yet. I have been pushing for this and even discussed it with the past and present Health Minister and Parliamentary Secretary for Justice. Of course, they have a lot on their plates.”
Prof. Mallia had explained that the double effect principle would allow a pregnant woman to receive treatment that indirectly harmed or killed her unborn baby.
“But if to save the mother one needs to directly kill the baby – such as the extreme case of a baby caught in the passage during delivery – then this does not follow double effect because the direct killing and dissecting of the baby is needed,” he said, stressing such cases were rare.
Abortion is strictly forbidden in Malta and there is no statutory legal provision to allow for the induced termination of a pregnancy, even to save a pregnant woman’s life.
In a homily earlier this month, Gozo Bishop Mario Grech said: “The direct killing of (unborn) children to save the mother is never acceptable.”
The Health Ministry was asked whether adequate medical safeguards were in place for women suffering life-threatening pregnancy complications.
It was also asked if legislation was being considered similar to that being proposed in Ireland, which would allow for abortion when a woman’s life was clearly in danger.
It concluded a detailed reply: “Malta does not consider that recourse to the use of abortion is an acceptable means of improving maternal and neonatal mortality and morbidity rates.
“Maternal mortality and morbidity are closely monitored on a national level and Malta will remain vigilant to maintain and improve the encouraging results it has achieved to date in reducing preventable maternal mortality and morbidity.”
It pointed out that maternal mortality in Malta was low, with two maternal deaths recorded from 2002 to 2011.
According to the UN Population Fund 2012 report, Malta’s maternal mortality ratio was eight deaths per 100,000 births.
On the other hand, Malta’s infant mortality rate was one of the highest in Europe, according to the most recent Eurostat figures, with 6.3 deaths per 1,000 children under one-year-old in 2011, compared to the EU average of 3.9.
Only Bulgaria had a higher rate among member states.
Speaking several years ago, the head of gynaecology, Mark Brincat, had attributed Malta’s relatively high infant mortality rate to the fact that babies with lethal congenital disorders were not aborted.
Principle of double effect
One may perform a good action even if it is foreseen that a bad effect will arise only if four conditions are met:
1) The act itself must be good.
2) The only thing that one can intend is the good act, not the foreseen but unintended bad effect.
3) The good effect cannot arise from the bad effect, otherwise one would do evil to achieve good.
4) The unintended but foreseen bad effect cannot be disproportionate to the good being performed.
Source: US National Catholic Bioethics Centre